Instructions for use CIPROFLOXACIN-AKOS
Carefully:
the drug is prescribed to patients with cerebral atherosclerosis, cerebrovascular accident, and convulsive syndrome.
Special instructions:
the solution in the form of eye drops is not intended for intraocular injection! The drug should not be injected subconjunctivally or directly into the anterior chamber of the eye! When using other ophthalmic drugs, the interval between their administration should be at least 5 minutes.
If after using the drops conjunctival hyperemia continues for a long time or increases, then you should stop using the drug and consult a doctor.
As with other antimicrobial drugs, long-term treatment with this drug may lead to overgrowth of non-susceptible microorganisms, including fungi.
If signs of increased inflammation appear during treatment with the described drug, appropriate therapy is prescribed. Depending on the clinical picture, a scheme for examining the patient’s eye is determined, including examination under magnification using a biomicroscope, as well as fluorescein staining.
When the first signs of hypersensitivity appear, such as skin rash and others, treatment with ciprofloxacin is stopped immediately.
Patients using soft and hard contact lenses should stop wearing lenses during treatment with the drug.
To reduce systemic absorption after instilling the drug, keep the eyelid closed for 2 minutes; it is recommended to press the area of the lacrimal canal with your fingers for 2 minutes.
Caution should be exercised when using fluoroquinolones, including Ciprofloxacin, in patients with known risk factors for QT prolongation:
- congenital long QT interval syndrome;
- concomitant use of drugs that are known to prolong the QT interval (eg, class IA and III antiarrhythmic drugs, tricyclic antidepressants, macrolides, antipsychotics);
- electrolyte disturbances, especially uncorrected hypokalemia, hypomagnesemia;
- women and elderly patients are more sensitive to the effects of drugs that prolong the QT interval, such as Ciprofloxacin, so special caution is required;
- heart disease (eg, heart failure, myocardial infarction, bradycardia).
The ability of a drug to influence the behavior or functional parameters of the body, interaction with tobacco, alcohol, food:
- Patients who temporarily lose clarity of vision after application are not recommended to drive a car or work with complex machinery, machines or any complex equipment that requires clarity of vision immediately after instillation of the drug.
Ciprofloxacin-AKOS eye drops 0.3% 5 ml bottle 1 pc. in Moscow
A broad-spectrum antibacterial drug of the fluoroquinolone group for topical use in ophthalmology and ENT practice. Suppresses bacterial DNA gyrase (topoisomerases II and IV, responsible for the process of supercoiling of chromosomal DNA around nuclear RNA, which is necessary for reading genetic information), disrupts DNA synthesis, growth and division of bacteria. Causes pronounced morphological changes (including cell wall and membranes) and rapid death of the bacterial cell.
It has a bactericidal effect on gram-negative organisms during the period of rest and division (since it affects not only DNA gyrase, but also causes lysis of the cell wall), on gram-positive microorganisms - only during the period of division.
Low toxicity for the cells of the macroorganism is explained by the absence of DNA gyrase in them. While taking ciprofloxacin, there is no parallel development of resistance to other actibiotics that do not belong to the group of gyrase inhibitors, which makes it highly effective against bacteria that are resistant, for example, to aminoglycosides, penicillins, cephalosporins, tetracyclines and many other antibiotics.
Active against gram-negative aerobic bacteria: Escherichia coli, Salmonella spp., Shigella spp., Citrobacter spp., Klebsiella spp., Enterobacter spp., Proteus mirabilis, Proteus vulgaris, Serratia marcescens, Hafnia alvei, Edwardsiella tarda, Providencia spp., Morganella morganii, Vibrio spp., Yersinia spp., Haemophilus spp., Pseudomonas aeruginosa, Moraxella catarrhalis, Aeromonas spp., Pasteurella multocida, Plesiomonas shigelloides, Campylobacter jejuni, Neisseria spp.;
gram-positive aerobic bacteria:
Staphylococcus spp.
(Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus), Streptococcus spp. (Streptococcus pyogenes, Streptococcus agalactiae); some intracellular pathogens:
Legionella pneumophila, Brucella spp., Chlamydia trachomatis, Listeria monocytogenes, Mycobacterium tuberculosis, Mycobacterium kansasii, Corynebacterium diphtheriae.
Moderately sensitive to ciprofloxacin (high concentrations are required to suppress them) Streptococcus pneumoniae, Enterococcus faecalis, Mycobacterium avium (located intracellularly).
Bacteroides fragilis, Pseudomonas cepacia, Pseudomonas maltophilia, Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides are resistant to ciprofloxacin
Most staphylococci resistant to methicillin are also resistant to ciprofloxacin.
Not effective against Treponema pallidum.
Resistance develops extremely slowly: on the one hand, after the action of ciprofloxacin there are practically no persistent microorganisms left, on the other hand, bacterial cells do not have enzymes that inactivate it.
Ciprofloxacin-AKOS (eye drops 0.3% 5ml)
A country
Russia
The country of production may vary depending on the batch of goods. Please check with the operator for detailed information when confirming your order.
Active substance
Ciprofloxacin
Compound
The active substance is ciprofloxacin.
pharmachologic effect
Pharmacological action - antibacterial (bactericidal). Inhibits DNA gyrase, disrupts DNA biosynthesis, growth and division of bacteria; causes pronounced morphological changes and rapid cell death. It affects microorganisms during the period of growth and dormancy. It is quickly and quite completely absorbed from the gastrointestinal tract, absorption occurs mainly in the duodenum and jejunum. The maximum concentration is achieved after 1-1.5 hours. Eating slows down absorption. Penetrates into tissues, fluids and cells, creating high concentrations in the kidneys, gall bladder, liver, lungs, bronchial and sinus mucosa, female genital organs, phagocytic cells, urine, sputum, bile, skin blister fluid; found in the prostate gland, cerebrospinal fluid, saliva, skin, adipose tissue, muscles, bones, cartilage, and passes through the placenta. Biotransformed in the liver. It is excreted mainly by the kidneys, a small amount is excreted by the lactating mammary glands. It has a wide spectrum of antimicrobial action, the most active against gram-negative bacteria, the effect on anaerobes is less pronounced. Has an effect on Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyogenes, Campylobacter jejuni, Citrobacter diversus, Citrobacter freundii, Enterobacter cloacaae, Escherichia coli, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Morganella morgan ii, Neisseria gonorrhoeae, Proteus mirabilis , Proteus vulgaris, Providencia rettgeri, Providencia stuartii, Pseudomonas aeruginosa, Salmonella typhi, Serratia marcescens, Shigella flexneri, Shigella sonnei, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus, Acinetobacter spp., Acinetobacter calcoaceticus, Aeromonas ca viae, Aeromonas hydrophilia, Brucella melitensis, Campylobacter coli, Edwardsiella tarda, Enterobacter aerogenes, Haemophilus ducreyi, Klebsiella oxytoca, Legionella pneumophila, Moraxella (Branhamella) catarrhalis, Neisseria meningitidis, Pasteurella multocida, Salmonella enteritidis, Vibrio cholerae, Vibrio parahaemolyticus, Vibrio vulnificus, Yersinia enterocolit ica, Chlamydia trachomatis, Mycobacterium tuberculosis . In an acidic environment, activity decreases.
Indications for use
Infections of the ENT organs (otitis media, sinusitis, mastoiditis, tonsillitis, pharyngitis), lower respiratory tract (acute bronchitis and exacerbation of chronic, pneumonia, except pneumococcal, bronchiectasis, cystic fibrosis), pelvic organs (cystitis, pyelonephritis, prostatitis, adnexitis, salpingitis, oophoritis, endometritis, tubular abscess, pelvic peritonitis), skin and soft tissues (infected ulcers, wounds, burns, infections of the external auditory canal, abscesses, cellulitis), bones and joints (osteomyelitis, septic arthritis), venereal diseases (gonorrhea, mild chancre, chlamydia), abdominal cavity (gallbladder and biliary tract, intraperitoneal abscesses, peritonitis, salmonellosis, including typhoid fever, campylobacteriosis, yersiniosis, shigellosis, cholera), bacteremia, septicemia, severe infections due to immunodeficiency and neutropenia, prevention of infections during surgical interventions. Local - infectious and inflammatory eye diseases (conjunctivitis, blepharoconjunctivitis, blepharitis, keratitis, keratoconjunctivitis, bacterial corneal ulcer).
Interaction
Activity increases when combined with beta-lactam antibiotics, aminoglycosides, vancomycin, clindamycin, metronidazole. Sucralfate, bismuth preparations, antacids containing aluminum, magnesium or calcium ions, cimetidine, ranitidine, vitamins with microelements, iron sulfate, zinc, didanosine, laxatives reduce absorption (it is recommended to use 2 hours before or 4 hours after these drugs). Probenecid and azlocillin increase concentrations in the blood. Reduces clearance and increases plasma levels of caffeine, aminophylline and theophylline (the likelihood of side effects increases). Enhances the effect of warfarin and other oral anticoagulants (extends bleeding time). Increases the nephrotoxicity of cyclosporine, the risk of increased excitability of the central nervous system and convulsive reactions against the background of NSAIDs. Drugs that alkalinize urine (citrates, sodium bicarbonate, carbonic anhydrase inhibitors) reduce solubility (the likelihood of crystalluria increases). Compatible with infusion solutions: 0.9% sodium chloride, Ringer's, Ringer-lactate, 5 and 10% glucose, 10% fructose, 5% glucose containing 0.225 or 0.45% sodium chloride. Incompatible with solutions having a pH above 7.
Side effect
Nausea, vomiting, loss of appetite, diarrhea, constipation, pseudomembranous colitis, epigastric and abdominal pain, abdominal discomfort, hiccups, ulcers, dryness and soreness of the oral mucosa, flatulence, bleeding in the gastrointestinal tract, pancreatitis, cholestatic jaundice, hepatitis, cell necrosis liver, headache, dizziness, agitation, anxiety, insomnia, nightmares, depression, phobias, feeling tired, visual impairment (chromatopsia, diplopia, nystagmus, eye pain), taste, smell, tinnitus, transient hearing impairment, mood changes, gait disturbance, increased intracranial pressure, paresthesia, sweating, ataxia, tremor, convulsions, toxic psychosis, paranoia, hallucinations, hyperpigmentation, eosinophilia, fever, photosensitivity, leukopenia, leukocytosis, anemia, thrombocytopenia, thrombocytosis, change in prothrombin level, transient increased liver transaminases, alkaline phosphatase, creatinine, urea, serum triglycerides, glucose, potassium, bilirubin, hypotension, syncope, cardiovascular collapse, arrhythmias, cerebral thrombosis, paroxysmal tachycardia, pulmonary embolism, dyspnea, respiratory distress, bronchospasm, pleural effusion, arthralgia , myalgia, tendovaginitis, frequent urination, crystalluria, hematuria, cylindruria, polyuria, proteinuria, acidosis, urinary retention, hemorrhagic cystitis, nephritis, vaginitis, gynecomastia, rash, petechiae, blisters, papules, cutaneous vasculitis, Stevens-Johnson syndrome, Lyell's syndrome , exudative erythema multiforme, exfoliative dermatitis, itching, swelling of the lips, face, neck, conjunctiva, extremities, angioedema, urticaria, anaphylactic shock, dysbacteriosis, candidiasis; at the site of intravenous administration - pain, burning sensation, phlebitis.
Contraindications
Hypersensitivity (including to other fluoroquinolones), glucose-6-phosphate dehydrogenase deficiency, childhood and adolescence (until the end of the period of intensive growth), pregnancy, breastfeeding.
Overdose
Symptoms: no specific symptoms. Treatment: gastric lavage, use of emetics, administration of large amounts of fluid, creation of an acidic urine reaction, additionally - hemodialysis and peritoneal dialysis; all activities are carried out against the background of maintaining vital functions.
special instructions
Prescribed with caution if there is a history of central nervous system pathology: mental illness, epilepsy, decreased convulsive threshold, apoplexy, severe atherosclerosis of cerebral vessels (risk of impaired blood supply, stroke), in old age, with severe impairment of renal and liver function (monitoring of plasma concentrations is required ). During the treatment period, you should avoid sun and UV irradiation, intense physical activity, and control your drinking regime and urine pH. It may reduce the speed of psychomotor reactions, especially in the presence of alcohol, which should be taken into account by patients working with potentially dangerous mechanisms or driving vehicles. If severe diarrhea develops, pseudomembranous colitis (for which ciprofloxacin is contraindicated) must be excluded. Simultaneous intravenous administration of barbiturates requires monitoring of the function of the cardiovascular system (blood pressure, ECG indicators). Adolescents under 18 years of age are prescribed only if the pathogen is resistant to other chemotherapeutic drugs.
Dispensing conditions in pharmacies
On prescription
